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Pitt Barnes S, Lang JE. Supporting School Staff: Insights From Employee Health and Well-Being Programs. THE JOURNAL OF SCHOOL HEALTH 2023; 93:842-852. [PMID: 37670593 DOI: 10.1111/josh.13377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND The workplace is an important setting for health protection, health promotion, and disease prevention programs. In the school setting, employee health and well-being programs can address many physical and emotional concerns of school staff. This systematic review summarizes evidence-based approaches from employee health and well-being interventions supporting nutrition and physical activity (PA) in a variety of workplace settings. METHODS The 2-phase systematic review included a search for articles within systematic reviews that met our criteria (addressing employee health and well-being programs; published 2010-2018; Phase 1) and the identification of individual articles from additional searches (addressing school-based employee interventions; published 2010-2020; Phase 2). We included 35 articles. FINDINGS Across all studies and types of interventions and workplace settings, findings were mixed; however, multicomponent interventions appeared to improve health behaviors and health outcomes among employees. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Schools can apply this evidence from employee health and well-being programs in various workplace settings to implement coordinated and comprehensive employee health and well-being programs. CONCLUSIONS Employee health and well-being programs may be effective at supporting nutrition and PA. Schools can use findings from employee health and well-being programs in workplaces other than schools to support school staff.
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Affiliation(s)
- Seraphine Pitt Barnes
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jason E Lang
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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2
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Barati Jozan MM, Ghorbani BD, Khalid MS, Lotfata A, Tabesh H. Impact assessment of e-trainings in occupational safety and health: a literature review. BMC Public Health 2023; 23:1187. [PMID: 37340453 DOI: 10.1186/s12889-023-16114-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/13/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Implementing workplace preventive interventions reduces occupational accidents and injuries, as well as the negative consequences of those accidents and injuries. Online occupational safety and health training is one of the most effective preventive interventions. This study aims to present current knowledge on e-training interventions, make recommendations on the flexibility, accessibility, and cost-effectiveness of online training, and identify research gaps and obstacles. METHOD All studies that addressed occupational safety and health e-training interventions designed to address worker injuries, accidents, and diseases were chosen from PubMed and Scopus until 2021. Two independent reviewers conducted the screening process for titles, abstracts, and full texts, and disagreements on the inclusion or exclusion of an article were resolved by consensus and, if necessary, by a third reviewer. The included articles were analyzed and synthesized using the constant comparative analysis method. RESULT The search identified 7,497 articles and 7,325 unique records. Following the title, abstract, and full-text screening, 25 studies met the review criteria. Of the 25 studies, 23 were conducted in developed and two in developing countries. The interventions were carried out on either the mobile platform, the website platform, or both. The study designs and the number of outcomes of the interventions varied significantly (multi-outcomes vs. single-outcome). Obesity, hypertension, neck/shoulder pain, office ergonomics issues, sedentary behaviors, heart disease, physical inactivity, dairy farm injuries, nutrition, respiratory problems, and diabetes were all addressed in the articles. CONCLUSION According to the findings of this literature study, e-trainings can significantly improve occupational safety and health. E-training is adaptable, affordable, and can increase workers' knowledge and abilities, resulting in fewer workplace injuries and accidents. Furthermore, e-training platforms can assist businesses in tracking employee development and ensuring that training needs are completed. Overall, this analysis reveals that e-training has enormous promise in the field of occupational safety and health for both businesses and employees.
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Affiliation(s)
- Mohammad Mahdi Barati Jozan
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Md Saifuddin Khalid
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Aynaz Lotfata
- School Of Veterinary Medicine, Department Of Veterinary Pathology, University of California, Davis, USA
| | - Hamed Tabesh
- Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Moe-Byrne T, Shepherd J, Merecz-Kot D, Sinokki M, Naumanen P, Hakkaart-van Roijen L, Van Der Feltz-Cornelis C. Effectiveness of tailored digital health interventions for mental health at the workplace: A systematic review of randomised controlled trials. PLOS DIGITAL HEALTH 2022; 1:e0000123. [PMID: 36812547 PMCID: PMC9931277 DOI: 10.1371/journal.pdig.0000123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/09/2022] [Indexed: 06/08/2023]
Abstract
Mental health problems in the workplace are common and have a considerable impact on employee wellbeing and productivity. Mental ill-health costs employers between £33 billion and £42 billion a year. According to a 2020 HSE report, roughly 2,440 per 100,000 workers in the UK were affected by work-related stress, depression, or anxiety, resulting in an estimated 17.9 million working days lost. We performed a systematic review of randomised controlled trials (RCTs) to assess the effect of tailored digital health interventions provided in the workplace aiming to improve mental health, presenteeism and absenteeism of employees. We searched several databases for RCTs published from 2000 onwards. Data were extracted into a standardised data extraction form. The quality of the included studies was assessed using the Cochrane Risk of Bias tool. Due to the heterogeneity of outcome measures, narrative synthesis was used to summarise the findings. Seven RCTs (eight publications) were included that evaluated tailored digital interventions versus waiting list control or usual care to improve physical and mental health outcomes and work productivity. The results are promising to the advantage of tailored digital interventions regarding presenteeism, sleep, stress levels, and physical symptoms related to somatisation; but less for addressing depression, anxiety, and absenteeism. Even though tailored digital interventions did not reduce anxiety and depression in the general working population, they significantly reduced depression and anxiety in employees with higher levels of psychological distress. Tailored digital interventions seem more effective in employees with higher levels of distress, presenteeism or absenteeism than in the general working population. There was high heterogeneity in outcome measures, especially for work productivity; this should be a focus of attention in future studies.
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Affiliation(s)
| | - Jessie Shepherd
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Marjo Sinokki
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Päivi Naumanen
- Turku Centre for Occupational Health, University of Turku, Turku, Finland
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Christina Van Der Feltz-Cornelis
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
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Imai Y, Mizuno Tanaka S, Satoh M, Hirata T, Murakami Y, Miura K, Waki T, Hirata A, Sairenchi T, Irie F, Sata M, Ninomiya T, Ohkubo T, Ishikawa S, Miyamoto Y, Ohnishi H, Saitoh S, Tamakoshi A, Yamada M, Kiyama M, Iso H, Sakata K, Nakagawa H, Okayama A, Ueshima H, Okamura T. Prediction of Lifetime Risk of Cardiovascular Disease Deaths Stratified by Sex in the Japanese Population. J Am Heart Assoc 2021; 10:e021753. [PMID: 34845914 PMCID: PMC9075349 DOI: 10.1161/jaha.121.021753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Lifetime risk is an informative estimate for driving lifestyle and behavioral changes especially for young adults. The impact of composite risk factors for cardiovascular disease on lifetime risk stratified by sex has not been investigated in the Japanese population, which has a much lower mortality of coronary heart disease compared with the Western population. We aimed to estimate lifetime risk of death from cardiovascular disease attributable to traditional risk factors. Methods and Results We analyzed pooled individual data from the Evidence for Cardiovascular Prevention from Observational Cohorts in a Japanese cohort study. A modified Kaplan–Meier approach was used to estimate the remaining lifetime risk of cardiovascular death. In total, 41 002 Japanese men and women with 537 126 person‐years of follow‐up were included. The lifetime risk at the index‐age of 45 years for those with optimal risk factors (total cholesterol <4.65 mmol/L, systolic blood pressure <120 mm Hg, diastolic blood pressure <80 mm Hg, absence of diabetes, and absence of smoking habit) was lower compared with the highest risk profile of ≥2 risk factors (6.8% [95% CI, 0%–11.9%] versus 19.4% [16.7%–21.4%] for men and 6.9% [1.2%–11.5%] versus 15.4% [12.6%–18.1%] for women). Conclusions The magnitude and the number of risk factors were progressively associated with increased lifetime risk even in individuals in early adulthood who tend to have low short‐term risk. The degree of established cardiovascular risk factors can be converted into lifetime risk. Our findings may be useful for risk communication in the early detection of future cardiovascular disease risk.
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Affiliation(s)
- Yukiko Imai
- Department of Preventive Medicine and Public Health School of Medicine Keio University Tokyo Japan
| | | | - Michihiro Satoh
- Division of Public Health, Hygiene, and Epidemiology Tohoku Medical and Pharmaceutical University Sendai Japan
| | - Takumi Hirata
- Department of Public Health Hokkaido University Faculty of Medicine Sapporo Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics Toho University School of Medicine Tokyo Japan
| | - Katsuyuki Miura
- Department of Public Health Center for Epidemiologic Research in AsiaShiga University of Medical Science Shiga Japan
| | - Takashi Waki
- Department of Medical Statistics Shiga University of Medical Science Shiga Japan
| | - Aya Hirata
- Department of Preventive Medicine and Public Health School of Medicine Keio University Tokyo Japan
| | - Toshimi Sairenchi
- Department of Public Health Dokkyo Medical University School of Medicine Tochigi Japan
| | - Fujiko Irie
- Department of Health and Welfare Ibaraki Prefectural Office Ibaraki Japan
| | - Mizuki Sata
- Department of Preventive Medicine and Public Health School of Medicine Keio University Tokyo Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health Teikyo University School of Medicine Tokyo Japan
| | | | - Yoshihiro Miyamoto
- Department of Preventive Medicine and Epidemiologic Informatics National Cerebral and Cardiovascular Center Osaka Japan
| | - Hirofumi Ohnishi
- Department of Public Health Sapporo Medical University Sapporo Japan
| | - Shigeyuki Saitoh
- Department of Nursing Sapporo Medical University School of Health Sciences Sapporo Japan
| | - Akiko Tamakoshi
- Department of Public Health Hokkaido University Faculty of Medicine Sapporo Japan
| | - Michiko Yamada
- Department of Clinical Studies Radiation Effects Research Foundation Hiroshima Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine Iwate Medical University School of Medicine Iwate Japan
| | - Hideaki Nakagawa
- Department of Social and Environmental Medicine Kanazawa Medical University Kanazawa Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention Tokyo Japan
| | - Hirotsugu Ueshima
- Department of Public Health Center for Epidemiologic Research in AsiaShiga University of Medical Science Shiga Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health School of Medicine Keio University Tokyo Japan
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Ryu H, Jung J, Moon J. Effectiveness of a Mobile Health Management Program With a Challenge Strategy for Improving the Cardiovascular Health of Workers. J Occup Environ Med 2021; 63:e132-e137. [PMID: 33395169 DOI: 10.1097/jom.0000000000002130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Workers' cardiovascular health can be influenced by individual willingness to practice healthy behaviors. A mobile health management program with a challenge strategy was administered to promote workers' healthy behaviors among small to medium-sized enterprises. METHODS A 12-week program consisted of health communication with a challenge strategy was administered to the workers. RESULTS The intervention group showed significantly improved scores for cardiovascular disease-related health behavior (Z = -2.44, P = 0.013), the job stress contributing factor of inadequate social support (F = 4.10, P = 0.049), and the cardiovascular disease-related health status of waist circumference (t = 3.22, P = 0.004), body fat (Z = -2.23, P = 0.024), and triglycerides (Z = -3.04, P = 0.001). CONCLUSION This study's significance is its potential for increasing the convenience and joy of participating in intervention programs and acquiring health information through mobile platforms, which are easily accessible to the workers.
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Affiliation(s)
- Hosihn Ryu
- College of Nursing, Korea University, Seoul, Republic of Korea
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Investigating the Factors Influencing the Attitudes of Workplace Employees Toward Paying to Use Technology-Based Health Care Products. J Occup Environ Med 2020; 62:e340-e347. [DOI: 10.1097/jom.0000000000001897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Widmer RJ, Senecal C, Allison TG, Lopez-Jimenez F, Lerman LO, Lerman A. Dose-Response Effect of a Digital Health Intervention During Cardiac Rehabilitation: Subanalysis of Randomized Controlled Trial. J Med Internet Res 2020; 22:e13055. [PMID: 32130116 PMCID: PMC7066512 DOI: 10.2196/13055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/19/2019] [Accepted: 04/23/2019] [Indexed: 12/21/2022] Open
Abstract
Background Previous data have validated the benefit of digital health interventions (DHIs) on weight loss in patients following acute coronary syndrome entering cardiac rehabilitation (CR). Objective The primary purpose of this study was to test the hypothesis that increased DHI use, as measured by individual log-ins, is associated with improved weight loss. Secondary analyses evaluated the association between log-ins and activity within the platform and exercise, dietary, and medication adherence. Methods We obtained DHI data including active days, total log-ins, tasks completed, educational modules reviewed, medication adherence, and nonmonetary incentive points earned in patients undergoing standard CR following acute coronary syndrome. Linear regression followed by multivariable models were used to evaluate associations between DHI log-ins and weight loss or dietary adherence. Results Participants (n=61) were 79% male (48/61) with mean age of 61.0 (SD 9.7) years. We found a significant positive association of total log-ins during CR with weight loss (r2=.10, P=.03). Educational modules viewed (r2=.11, P=.009) and tasks completed (r2=.10, P=.01) were positively significantly associated with weight loss, yet total log-ins were not significantly associated with differences in dietary adherence (r2=.05, P=.12) or improvements in minutes of exercise per week (r2=.03, P=.36). Conclusions These data extend our previous findings and demonstrate increased DHI log-ins portend improved weight loss in patients undergoing CR after acute coronary syndrome. DHI adherence can potentially be monitored and used as a tool to selectively encourage patients to adhere to secondary prevention lifestyle modifications. Trial Registration ClinicalTrials.gov (NCT01883050); https://clinicaltrials.gov/ct2/show/NCT01883050
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Affiliation(s)
- R Jay Widmer
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Conor Senecal
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Thomas G Allison
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | | | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States
| | - Amir Lerman
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
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Stein RI, Strickland JR, Tabak RG, Dale AM, Colditz GA, Evanoff BA. Design of a randomized trial testing a multi-level weight-control intervention to reduce obesity and related health conditions in low-income workers. Contemp Clin Trials 2019; 79:89-97. [PMID: 30664943 PMCID: PMC6521952 DOI: 10.1016/j.cct.2019.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 12/13/2022]
Abstract
Weight-control is a major public health focus for preventing multiple obesity-related health conditions. While clinic-based intensive lifestyle interventions are successful, low-socioeconomic-status (SES) populations, which have a higher burden of obesity, are difficult to reach; thus, the workplace offers a useful setting to target low-SES workers. The current paper presents the design of a study testing a workplace intervention aimed at low-SES employees. Partnering with a large healthcare system and affiliated university, this project will test an innovative multi-level intervention ("Working for You") adapted from existing group- and individual-level intervention models to promote healthy weight among low-wage workers. The individual-level component is an interactive obesity treatment approach (iOTA) program that involves assessment of behavior risks, collaborative goal-setting with a health coach, and interactive SMS text-messages for ongoing support and self-monitoring. This mHealth intervention is embedded in the group-level component, a workplace participatory program that involves worker teams engaged in the design and implementation of interventions to change their workplace environments. These nested interventions are being tested in a group-randomized trial among 22 work groups (~1000 total workers, ~300 workers with obesity). The primary outcome will be program effects on weight at 2-year follow-up, compared to control, and the secondary outcomes will be effects on diet and physical activity; iOTA adherence, process measures, and work environment/support will also be examined. This pragmatic clinical trial will test scalable interventions that can be translated to other work settings to reduce obesity and related health risks among low-SES workers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02934113.
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Affiliation(s)
- Richard I Stein
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States.
| | - Jaime R Strickland
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Rachel G Tabak
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Ann Marie Dale
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Graham A Colditz
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Bradley A Evanoff
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
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Asan O, Cooper Ii F, Nagavally S, Walker RJ, Williams JS, Ozieh MN, Egede LE. Preferences for Health Information Technologies Among US Adults: Analysis of the Health Information National Trends Survey. J Med Internet Res 2018; 20:e277. [PMID: 30341048 PMCID: PMC6245956 DOI: 10.2196/jmir.9436] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/19/2018] [Accepted: 05/10/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Emerging health technologies are increasingly being used in health care for communication, data collection, patient monitoring, education, and facilitating adherence to chronic disease management. However, there is a lack of studies on differences in the preference for using information exchange technologies between patients with chronic and nonchronic diseases and factors affecting these differences. OBJECTIVE The purpose of this paper is to understand the preferences and use of information technology for information exchange among a nationally representative sample of adults with and without 3 chronic disease conditions (ie, cardiovascular disease [CVD], diabetes, and hypertension) and to assess whether these preferences differ according to varying demographic variables. METHODS We utilized data from the 2012 and 2014 iteration of the Health Information National Trends Survey (N=7307). We used multiple logistic regressions, adjusting for relevant demographic covariates, to identify the independent factors associated with lower odds of using health information technology (HIT), thus, identifying targets for awareness. Analyses were weighted for the US population and adjusted for the sociodemographic variables of age, gender, race, and US census region. RESULTS Of 7307 participants, 3529 reported CVD, diabetes, or hypertension. In the unadjusted models, individuals with diabetes, CVD, or hypertension were more likely to report using email to exchange medical information with their provider and less likely to not use any of the technology in health information exchange, as well as more likely to say it was not important for them to access personal medical information electronically. In the unadjusted model, additional significant odds ratio (OR) values were observed. However, after adjustment, most relationships regarding the use and interest in exchanging information with the provider were no longer significant. In the adjusted model, individuals with CVD, diabetes, or hypertension were more likely to access Web-based personal health information through a website or app. Furthermore, we assessed adjusted ORs for demographic variables. Those aged >65 years and Hispanic people were more likely to report no use of email to exchange medical information with their provider. Minorities (Hispanic, non-Hispanic black, and Asian people) were less likely to indicate they had no interest in exchanging general health tips with a provider electronically. CONCLUSIONS The analysis did not show any significant association among those with comorbidities and their proclivity toward health information, possibly implying that HIT-related interventions, particularly design of information technologies, should focus more on demographic factors, including race, age, and region, than on comorbidities or chronic disease status to increase the likelihood of use. Future research is needed to understand and explore more patient-friendly use and design of information technologies, which can be utilized by diverse age, race, and education or health literacy groups efficiently to further bridge the patient-provider communication gap.
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Affiliation(s)
- Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Farion Cooper Ii
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sneha Nagavally
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States
| | - Rebekah J Walker
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States
| | - Joni S Williams
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States
| | - Mukoso N Ozieh
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States
| | - Leonard E Egede
- Center for Advancing Population Science (CAPS), Medical College of Wisconsin, Milwaukee, WI, United States
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Senecal C, Widmer RJ, Johnson MP, Lerman LO, Lerman A. Digital health intervention as an adjunct to a workplace health program in hypertension. ACTA ACUST UNITED AC 2018; 12:695-702. [DOI: 10.1016/j.jash.2018.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/01/2018] [Accepted: 05/18/2018] [Indexed: 01/21/2023]
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Klimis H, Thakkar J, Chow CK. Breaking Barriers: Mobile Health Interventions for Cardiovascular Disease. Can J Cardiol 2018; 34:905-913. [DOI: 10.1016/j.cjca.2018.02.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/07/2018] [Accepted: 02/11/2018] [Indexed: 11/30/2022] Open
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Brown SA, García AA, Zuñiga JA, Lewis KA. Effectiveness of workplace diabetes prevention programs: A systematic review of the evidence. PATIENT EDUCATION AND COUNSELING 2018; 101:1036-1050. [PMID: 29339040 DOI: 10.1016/j.pec.2018.01.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 12/16/2017] [Accepted: 01/04/2018] [Indexed: 06/07/2023]
Abstract
PURPOSE The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM. METHODS Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017. RESULTS The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions-healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors-were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24 weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive. CONCLUSION The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes. PRACTICE IMPLICATIONS Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered.
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Senecal C, Widmer RJ, Bailey K, Lerman LO, Lerman A. Usage of a Digital Health Workplace Intervention Based on Socioeconomic Environment and Race: Retrospective Secondary Cross-Sectional Study. J Med Internet Res 2018; 20:e145. [PMID: 29685862 PMCID: PMC5938596 DOI: 10.2196/jmir.8819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 01/23/2018] [Accepted: 02/24/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Digital health tools have been associated with improvement of cardiovascular disease (CVD) risk factors and outcomes; however, the differential use of these technologies among various ethnic and economic classes is not well known. OBJECTIVE To identify the effect of socioeconomic environment on usage of a digital health intervention. METHODS A retrospective secondary cross-sectional analysis of a workplace digital health tool use, in association with a change in intermediate markers of CVD, was undertaken over the course of one year in 26,188 participants in a work health program across 81 organizations in 42 American states between 2011 and 2014. Baseline demographic data for participants included age, sex, race, home zip code, weight, height, blood pressure, glucose, lipids, and hemoglobin A1c. Follow-up data was then obtained in 90-day increments for up to one year. Using publicly available data from the American Community Survey, we obtained the median income for each zip code as a marker for socioeconomic status via median household income. Digital health intervention usage was analyzed based on socioeconomic status as well as age, gender, and race. RESULTS The cohort was found to represent a wide sample of socioeconomic environments from a median income of US $11,000 to $171,000. As a whole, doubling of income was associated with 7.6% increase in log-in frequency. However, there were marked differences between races. Black participants showed a 40.5% increase and Hispanic participants showed a 57.8% increase in use with a doubling of income, compared to 3% for Caucasian participants. CONCLUSIONS The current study demonstrated that socioeconomic data confirms no relevant relationship between socioeconomic environment and digital health intervention usage for Caucasian users. However, a strong relationship is present for black and Hispanic users. Thus, socioeconomic environment plays a prominent role only in minority groups that represent a high-risk group for CVD. This finding identifies a need for digital health apps that are effective in these high-risk groups.
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Howarth A, Quesada J, Silva J, Judycki S, Mills PR. The impact of digital health interventions on health-related outcomes in the workplace: A systematic review. Digit Health 2018; 4:2055207618770861. [PMID: 29942631 PMCID: PMC6016571 DOI: 10.1177/2055207618770861] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/20/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The impact of employee health on productivity in the workplace is generally evidenced through absenteeism and presenteeism. Multicomponent worksite health programmes, with significant online elements, have gained in popularity over the last two decades, due in part to their scalability and low cost of implementation. However, little is known about the impact of digital-only interventions on health-related outcomes in employee groups. The aim of this systematic review was to assess the impact of pure digital health interventions in the workplace on health-related outcomes. METHODS Multiple databases, including MEDLINE, EMBASE, PubMed and PsycINFO, were used to review the literature using PRISMA guidelines. RESULTS Of 1345 records screened, 22 randomized controlled trial studies were found to be eligible. Although there was a high level of heterogeneity across these studies, significant improvements were found for a broad range of outcomes such as sleep, mental health, sedentary behaviours and physical activity levels. Standardized measures were not always used to quantify intervention impact. All but one study resulted in at least one significantly improved health-related outcome, but attrition rates ranged widely, suggesting sustaining engagement was an issue. Risk of bias assessment was low for one-third of the studies and unclear for the remaining ones. CONCLUSIONS This review found modest evidence that digital-only interventions have a positive impact on health-related outcomes in the workplace. High heterogeneity impacted the ability to confirm what interventions might work best for which health outcomes, although less complex health outcomes appeared to be more likely to be impacted. A focus on engagement along with the use of standardized measures and reporting of active intervention components would be helpful in future evaluations.
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Affiliation(s)
- Ana Howarth
- Cigna, Global Well-being Solutions Ltd, UK
- Population Health Research Institute, St George’s, University of London, UK
| | | | | | | | - Peter R Mills
- Cigna, Global Well-being Solutions Ltd, UK
- Department of Respiratory Medicine, The Whittington Hospital NHS Trust, UK
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Widmer RJ, Allison TG, Lennon R, Lopez-Jimenez F, Lerman LO, Lerman A. Digital health intervention during cardiac rehabilitation: A randomized controlled trial. Am Heart J 2017; 188:65-72. [PMID: 28577682 DOI: 10.1016/j.ahj.2017.02.016] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/06/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Digital health interventions (DHI) have been shown to improve intermediates of cardiovascular health, but their impact on cardiovascular (CV) outcomes has not been fully explored. The aim of this study was to determine whether DHI administered during cardiac rehabilitation (CR) would reduce CV-related emergency department (ED) visits and rehospitalizations in patients after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). METHODS We randomized patients undergoing CR following ACS and PCI to standard CR (n=40) or CR+DHI (n=40) for 3 months with 3 patients withdrawing from CR prior to initiation in the treatment arm and 6 in the control group. The DHI incorporated an online and smartphone-based CR platform asking the patients to report of dietary and exercise habits throughout CR as well as educational information toward patients' healthy lifestyles. We obtained data regarding ED visits and rehospitalizations at 180 days, as well as other metrics of secondary CV prevention at baseline and 90 days. RESULTS Baseline demographics were similar between the groups. The DHI+CR group had improved weight loss compared to the control group (-5.1±6.5 kg vs. -0.8±3.8 kg, respectively, P=.02). Those in the DHI+CR group also showed a non-significant reduction in CV-related rehospitalizations plus ED visits compared to the control group at 180 days (8.1% vs 26.6%; RR 0.30, 95% CI 0.08-1.10, P=.054). CONCLUSIONS The current study demonstrated that complementary DHI significantly improves weight loss, and might offer a method to reduce CV-related ED visits plus rehospitalizations in patients after ACS undergoing CR. The study suggests a role for DHI as an adjunct to CR to improve secondary prevention of CV disease. TRIAL REGISTRATION This trial is registered at clinicaltrials.gov (NCT01883050).
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Affiliation(s)
- R Jay Widmer
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Thomas G Allison
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Ryan Lennon
- Division of Biostatistics, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Francisco Lopez-Jimenez
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Amir Lerman
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
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